Individual provider Active NPI

Bartley R Richards, DO

  • Family Medicine Physician
  • Jefferson, GA
National Provider Identifier
1508962911
Registry record updated Jun 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
033883 Issued in GA
Practice address
1654 Washington St
Jefferson, GA 30549-2666
Phone
(706) 367-5006
Fax
(706) 367-7711
NPI assigned
Sep 15, 2006
Last updated
Jun 25, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 033883 GA Primary

Addresses

Primary practice location

1654 Washington St
Jefferson, GA 30549-2666

Mailing address

1654 Washington St
Jefferson, GA 30549-2666
Phone (706) 367-5006

Other identifiers 1

IdentifierTypeStateIssuer
000511662DMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041020000157 GA Practitioner - Family Practice 3577524909 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1654 Washington St
Jefferson, GA 30549-2666
Phone (706) 367-5006

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
033883GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bartley R. Richards, DO PC CurrentSince Mar 11, 2004 Accepting new patients
Peak Rehabilitation, Inc PastSince Oct 1, 2004 Accepting new patients

Locations

1654 Washington St
Jefferson, GA 30549
Phone (706) 367-5006

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372118400000",
    "number": "1508962911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1654 WASHINGTON ST",
            "city": "JEFFERSON",
            "state": "GA",
            "postal_code": "305492666",
            "telephone_number": "706-367-5006",
            "fax_number": "706-367-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1654 WASHINGTON ST",
            "city": "JEFFERSON",
            "state": "GA",
            "postal_code": "305492666",
            "telephone_number": "706-367-5006",
            "fax_number": "706-367-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDS",
        "first_name": "BARTLEY",
        "middle_name": "R",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2013-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "033883",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000511662D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson, GA

Sources for this page

Verify at the official NPI Registry.